Public funding spurs couples to seek fertility treatment

May 16, 2013 by Kathleen Doheny, Healthday Reporter
Public funding spurs couples to seek fertility treatment
After Quebec mandated IVF coverage, study found change in patient demographics.

(HealthDay)—Public funding of assisted reproductive technology, including in vitro fertilization (IVF) treatments, broadens the range of couples who seek treatment for infertility by attracting a more diverse population, according to new research from Canada.

When the began to fund up to three cycles of IVF in August 2010, researchers compared patients who sought that before and after the mandate.

Afterward, "we found larger numbers of lower income, less well-educated, unemployed people seeking ," said Phyllis Zelkowitz, director of research in the department of psychiatry and senior investigator at the Lady Davis Institute of the Jewish General Hospital, in Montreal.

The study is published in the May 16 New England Journal of Medicine.

For the study, Zelkowitz and her colleagues compared data on nearly 3,600 . Of those, 436 sought treatment before the policy change, 821 immediately after and 2,316 eight months after the policy change.

The investigators found the proportion of treated couples with college degrees declined from 68 percent to 63 percent eight months later. Unemployed couples seeking treatment rose from 3.6 percent to 11.6 percent. And the proportion of patients with household incomes of $65,000 a year or less increased from about 37 percent to more than 47 percent.

For white couples, the proportion dropped from about 67 percent to 63 percent in the eight-month period, after rising immediately after the policy change.

Zelkowitz also found the rate of couples seeking treatment for secondary infertility doubled from 14 percent to 29 percent. Secondary infertility means being unable to get pregnant or carry a pregnancy to term after having one or more biological children.

The mandated came with stipulations, Zelkowitz said. It approved coverage for up to three treatment cycles of IVF. It mandated the transfer of only one embryo per treatment cycle, with a goal of reducing preterm births, she noted.

Preterm births are more common with multiple pregnancies and are riskier to the babies, experts agree.

"One of the goals of the funding was to reduce preterm births, and they have already done that," Zelkowitz said.

The study findings are in conflict with earlier U.S. studies, which have shown that even when patients have access to public funding for , barriers continue to exist, including social, economic and ethnic obstacles. As a result, these earlier studies suggested, the typical patients remain older, wealthier, more-educated white couples.

In the United States, infertility affects about one of eight women of reproductive age and their partners, according to the American Society for Reproductive Medicine.

Currently, 15 states have passed laws that mandate insurers to cover or offer coverage for diagnosis and treatment, but some states exclude coverage for IVF.

Assisted reproductive technology is typically defined as fertility treatments in which both eggs and sperm are handled, such as IVF, but not procedures such as taking medicine to stimulate egg production, according to the U.S. Centers for Disease Control and Prevention.

Only about 5 percent of infertile couples need assisted , the society estimates.

For others, egg stimulation or lifestyle changes such as losing weight or stopping smoking can help them achieve a pregnancy.

However, for those who do need IVF, the cost can be prohibitive. A cycle of IVF costs about $12,400, the society estimates.

The study findings about patient demographics changing after became available do not surprise Dr. Wendy Schillings, a fertility specialist in Allentown, Pa. When she meets patients who have only diagnosis covered, she said, they often delay treatment if they need IVF, hoping to save up the money needed.

Couples who don't have IVF coverage often ask for more embryos to be transferred, she said, and she then counsels them on the risks of multiple births.

"Absolutely lower-income couples can do it [seek treatment] and will do it," Schillings said. However, for those with higher incomes, the decision may involve fewer sacrifices, she added.

Explore further: Good quality of life for couples who adopt

More information: To learn more about infertility coverage, state by state, visit the National Conference of State Legislatures.

Related Stories

Good quality of life for couples who adopt

November 12, 2012
Couples who adopt after unsuccessful IVF treatment have a better quality of life than both childless couples and couples without fertility problems, reveals a study from the Sahlgrenska Academy, University of Gothenburg, ...

UK may allow IVF for older women, same-sex couples

May 22, 2012
(AP) -- A powerful health advisory agency says Britain should extend free fertility treatments to women up to age 42 as well as same-sex couples, recommendations likely to be followed by many of the U.K.'s medical centers.

Birth rates good after implanting one embryo, study finds

May 8, 2013
(HealthDay)—Among women who undergo in vitro fertilization (IVF) to become pregnant, there is no difference in delivery rates among those implanted with one prescreened embryo compared to those implanted with two unscreened ...

States with fertility treatment insurance coverage have fewer births

October 21, 2011
(Medical Xpress) -- Fourteen states now mandate partial or comprehensive health insurance coverage of fertility treatment. These mandates have resulted in more women using assisted reproductive technologies (ART).

Recommended for you

Vitamin E-deficient embryos are cognitively impaired even after diet improves

July 27, 2017
Zebrafish deficient in vitamin E produce offspring beset by behavioral impairment and metabolic problems, new research at Oregon State University shows.

Sugar not so sweet for mental health

July 27, 2017
Sugar may be bad not only for your teeth and your waistline, but also your mental health, claimed a study Thursday that was met with scepticism by other experts.

Could insufficient sleep be adding centimeters to your waistline?

July 27, 2017
Adults in the UK who have poor sleep patterns are more likely to be overweight and obese and have poorer metabolic health, according to a new study.

The role of dosage in assessing risk of hormone therapy for menopause

July 27, 2017
When it comes to assessing the risk of estrogen therapy for menopause, how the therapy is delivered—taking a pill versus wearing a patch on one's skin—doesn't affect risk or benefit, researchers at UCLA and elsewhere ...

Blowing smoke? E-cigarettes might help smokers quit

July 26, 2017
People who used e-cigarettes were more likely to kick the habit than those who didn't, a new study found.

Brain disease seen in most football players in large report

July 25, 2017
Research on 202 former football players found evidence of a brain disease linked to repeated head blows in nearly all of them, from athletes in the National Football League, college and even high school.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.